A former World Health Organisation (WHO) director has accused the agency of ignoring science and blocking progress on tobacco harm reduction.
Professor Tikki Pang warns that the WHO’s current position risks stalling efforts to cut smoking in the Asia-Pacific – the region with the highest number of smokers in the world.
Pang, a senior global health consultant at the Center for Healthcare Policy and Reform Studies in Jakarta and former Director of Research Policy and Cooperation at the WHO, made the remarks during a webinar organised by the Asia Forum on Nicotine (AFN).
The event in August, titled “The WHO FCTC, 20 years on,” examined two decades of tobacco control under the WHO Framework Convention on Tobacco Control (FCTC) and debated the future role of harm reduction.
“The Asia-Pacific region bears a very significant burden of these harmful effects of smoking,” Pang said. “Despite the fact that Article 1 of the convention implicitly includes harm reduction as a component of tobacco control, there is a failure to acknowledge and support the use of safer alternative tobacco products as an important strategy and tool to end smoking.”
‘Contradicting science’
Pang criticised the WHO’s current approach, saying it “contradicts science” and fails to reflect the growing body of evidence supporting safer nicotine alternatives.
“Despite the overwhelming evidence of the safety, efficacy and cost-effectiveness of these products, and the fact that 130 million people are actually using these safer alternatives, the WHO, FCTC and the COP have adopted a very strong anti-tobacco harm reduction stance,” he said.
He noted that the WHO continues to claim that products such as vapes, heated tobacco and nicotine pouches are “as harmful as combustible cigarettes,” while praising countries that have banned them.
Asia-Pacific’s smoking crisis
According to Nancy Loucas, executive coordinator of the Coalition of Asia-Pacific Tobacco Harm Reduction Advocates (CAPHRA), the region accounts for almost two-thirds of global tobacco use.
“The fact is that Asia-Pacific, specifically Asia, has the highest number of global tobacco users. The number is staggering. It is 781 million people. That represents 63 percent of the global total of people who use tobacco,” she said.
Loucas also criticised the agenda for the upcoming COP11 conference of the FCTC in November, arguing it wrongly dismisses harm reduction as a tobacco industry concept.
Building new coalitions
Rather than waiting for the WHO to change its position, Pang urged advocates to push forward through new partnerships. He called for “evidence-driven coalitions” that bring together researchers, consumers, investors and manufacturers, comparing the idea to the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA)model.
“In the years that I’ve become a supporter for tobacco harm reduction, and aside from the overwhelming scientific evidence of its value and benefits to health and smoking, I have been struck by the support the cause has received from many quarters – senior former colleagues at the WHO, highly respected academics and professional societies, physicians on the front lines, civil society, consumer groups, and of course, industry,” Pang said.
He added: “Reflecting on that, I sometimes wonder, we can’t all be wrong.”
Quoting Australian harm reduction advocate Dr Alex Wodak, Pang said: “WHO’s position on this issue is now as irrelevant as the position of governments in Eastern Europe and the Soviet Union in the 1980s on the future of central command economies. WHO’s position will collapse at some point, but I don’t know when.”
WHO urged to act at COP11
The Independent European Vape Alliance (IEVA) echoed Pang’s remarks ahead of COP11, calling on the WHO to “finally place harm reduction at the centre of the global tobacco control debate.”
“COP11 is an opportunity to bring scientific balance and evidence-based thinking into the global debate,” said Dustin Dahlmann, President of IEVA. “If WHO and governments continue to overlook harm reduction, the decline in smoking rates could stall – or even reverse.”
IEVA warned that millions of smokers could be left without effective alternatives if the WHO continues to treat all nicotine products as equally harmful. The alliance urged policymakers to recognise the role of flavours, proportionate regulation and factual communication in helping adult smokers switch away from cigarettes.
“We must move beyond ideology and focus on outcomes,” Dahlmann said. “Science shows that vaping helps smokers quit and reduces harm. A smoke-free future is only achievable if harm reduction and the availability of vaping flavours are recognised as central pillars of tobacco control.”
